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Prof. Dr. W.-H. Boehncke Zentrum der Dermatologie und Venerologie JWG-Universität

PSORIASIS AND CORONARY ARTERY CALCIFICATION (CAC). Prof. Dr. W.-H. Boehncke Zentrum der Dermatologie und Venerologie JWG-Universität Frankfurt am Main. PSORIASIS and co-morbidity. no. 1 co-morbidity: PSA! evidence for increased risk for cardiovascular mortality NEJM 1973, 288: 912

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Prof. Dr. W.-H. Boehncke Zentrum der Dermatologie und Venerologie JWG-Universität

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  1. PSORIASIS AND CORONARY ARTERY CALCIFICATION (CAC) Prof. Dr. W.-H. Boehncke Zentrum der Dermatologie und Venerologie JWG-Universität Frankfurt am Main

  2. PSORIASIS and co-morbidity • no. 1 co-morbidity: PSA! • evidence for increased risk for cardiovascular mortality • NEJM 1973, 288: 912 • BJD 1978, 99: 469 • JID 2001, 117: 1531 • Eur J Epidemiol 2004, 19: 225 • but: • more smokers • BJD 1996, 135: 859 • more diabetes • ADR 1975, 254: 43 • more hypertension • Dermatologica 1986, 172: 298 • so: What is the role of PSO? • background: • chronic inflammation causes atherosclerosis

  3. A ROLE FOR P-SELECTIN IN „ENDOTHELITIS“?

  4. Thrombocytes augment „rolling“ through formation of aggegates via P-selectin p<0.05 p<0.05 60 50 40 rolling fraction (PBMC) Platelet-PBMC- aggregates 30 20 PBMC alone 10 0 no resting activated platelets 11.9 28.1 CD41 6.7 CD3 Ludwig R, Schultz JE, Boehncke W-H et al. JID 2004, 122: 830

  5. Blockade of P-selectin dependent aggregate formation results in anti-inflammatory effects in-vivo p<0.05 40 25 p<0.05 20 30 rolling PMBC (%) 15 • ear swelling (cm x 10-3) 20 10 10 5 0 0 NaCl PS3 NaCl PS3 NaCl PS3 C57Bl/6 P-sel-/- Intravitalmicroscopy Contact Dermatitis p<0.05

  6. PSORIASIS AND CAC 30 20 PASI score 10 a 0 4 3 P-selectin (%) 2 b 1 0 after before 30 20 PASI score 10 c 0 0 1 2 4 3 P-selectin (%) • Is there a correlation between disease severity and P-selectin expression? • monitoring of in-patients • PASI • FACS

  7. PSORIASIS AND CAC • Are PSO patients at risk to develop cardiac disease? • 32 PSO patients • matched controls • spiral CT • CAC score (Agatston)

  8. „Psoriasis“ is a risk factor for coronary artery calicification 28.1% 71.9% 30 20 PASI score 10 a 0 4 3 P-selectin (%) 2 b 1 0 after before 30 20 PASI score 10 c 0 0 1 2 4 3 no CAC P-selectin (%) CAC prevalence severity controls * Psoriasis controls 59.4% 40.6% 0 50 100 150 200 250 CAC score patients Ludwig R, … Boehncke W-H. BJD, in press

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